Provider Demographics
NPI:1184993974
Name:ROBERTS, DEVENIA
Entity type:Individual
Prefix:
First Name:DEVENIA
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 GANDY BLVD N UNIT 1113
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2127
Mailing Address - Country:US
Mailing Address - Phone:252-955-2585
Mailing Address - Fax:
Practice Address - Street 1:3505 E FRONTAGE RD
Practice Address - Street 2:SUITE250
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1749
Practice Address - Country:US
Practice Address - Phone:813-365-2142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-22
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor